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05/05/2016 Paul Kesselman, DPM
Source for Size 18E SADMERC-Approved Shoes (Sharon Root, DPM)
Before answering your question, let me provide some background information to assist you with your query:
A) SADMERC was replaced by CMS many years ago with the Price Data Analysis Contractor (PDAC) which essentially performs the same functions as SADMERC;
B) SADMERC did away with the requirement(s) for product reviews and validation prior to its dissolution and the PDAC has continued that practice. That is, therapeutic shoes do not require a product validation as part of the Therapeutic Shoe for Patients with Diabetes (TSPD) program. However, they must meet the specifications for shoes which are stated in the policy (must be available in 3 widths, etc.). The inserts are another story. So this patient may now require custom inserts, but since these are made from raw materials, any distributor of stock shoes who also provides custom inserts should be able to assist you.
That being said, you have three choices to resolve this matter:
1) Find any shoe which comes in a size 18E. As long as that shoe meets the specification found in the policy, you should be fine. You should be able to obtain the specification from the mfg. I would search the usual websites which most consumers utilize in order to do some research such as Amazon, Zappos etc. in order to assist you. Many years ago I had a similar situation with a 12 year old female who wore a size 15 shoe. I had the parents reach out to the NY Liberty (WNBA team) whose marketing director assisted them in their quest for fashionable shoes for this patient. You may wish to reach out to college or professional sports teams in your area for similar referrals.
2) Punt this to a local pedorthic facility who likely has the purchasing power to deal with companies such as Nike and others which won't wholesale to you.
3) Should the above prove impossible, your last option is to have the patient casted for a custom fabricated shoe. Documentation to prove medical necessity is that the patient due to their deformities and the size of foot could not be accommodated by a stock extra depth shoe. You could state your inability to obtain such a shoe from many wholesalers. If you don't provide custom fabricated shoes, then again a referral to someone who can would be appropriate. I'll be interested in how this is resolved. Please keep us informed.
Paul Kesselman, DPM, Woodside, NY
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